Graduation Semester and Year
Summer 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Kristine Cope
Abstract
Background
During the development of the 2022 Tarrant County Public Health Community Health Assessment, two gaps were identified that contribute to disparities: transportation and access to healthcare in areas of high need (Y. M. Wingate, Ed.D., Community Health Assessment Division Manager, Tarrant County Public Health, personal communication, June 20, 2025). As of 2017, 5.8 million individuals reported delaying medical care due to a lack of accessible transportation in the U.S. (Wolfe et al., 2020). The National Health Interview Survey (NHIS) of 2022 reported that 5.9% of residents living in the West South-Central region, which includes Texas, found that, within the last 12 months, residents lacked access to reliable transportation to get to places such as work and medical appointments (Ng et al., 2022).
Methods
The Agency for Healthcare Research and Quality (AHRQ) framework systematically evaluates evidence for its strength and categorizes it using terms such as high, low, or insufficient (Dowell et al., 2022)(see Appendix A). Using the AHRQ framework to develop CPG provides confidence in the strength of the evidence (Dowell et al., 2022). The framework for developing this guideline for grading the level and quality of evidence is the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model (see Appendix B).
Results
Findings demonstrated strong stakeholder support for transportation-focused strategies and for the integration of routine social determinants of health (SDoH) assessment and documentation into clinical workflows. Ratings for technology-based strategies were comparatively lower, although still favorable. Overall, no statistically significant differences were observed among recommendations.
Conclusion
This clinical practice guideline offers a structured, evidence-based framework integrating non-emergency medical transportation (NEMT) and social determinants of health (SDoH) screening tools to enhance access to care for underserved adult populations in a North Central Texas county.
Keywords
Clinical practice guideline, Non-emergency medical transportation, Social determinants of health, Healthcare access, Health disparities, Underserved populations
Disciplines
Nursing
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Walker, Tammie E., "A Guideline for Underserved Adult Residents in Need of Affordable Transportation Access to Healthcare" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 5.
https://mavmatrix.uta.edu/nursing_dnpprojects2/5